Tube Function In Patients Research Articles

Role of preoperative tympanometric evaluation of eustachian tube in patients undergoing type-1 tympanoplasty for chronic otitis media

<p class="abstract"><strong>Background:</strong> A dysfunctional eustachian tube can cause failure of middle ear pressure regulation which leads to chronic otitis media and tympanoplasty failure. The functional status of eustachian tube can non-invasively be assessed prior to tympanoplasty by impedence audiometry. This help to predict the outcome of the procedure as well as aid surgeons to plan the surgery accordingly. The aim of the study was to determine the role of pre-operative tympanometric evaluation of eustachian tube function in patients with chronic otitis media.</p><p class="abstract"><strong>Methods:</strong> This study was conducted on 42 patients with chronic otitis media underwent type-1 tympanoplasty in department of otorhinolaryngology, Government Medical College, Kottayam over a period of one year. Detailed history, clinical and audiological evaluation done. Type-1 tympanoplasty performed and reassessed after 3 months. Data compiled and analysed using SPSS.</p><p class="abstract"><strong>Results:</strong> Intra-operative findings were similar to the audiometric results. Majority of patients with dysfunctional eustachian tube got a non-satisfactory hearing outcome compared to patients with good eustachian tube function, and this comparison is statistically significant with p value 0.006. The graft uptake in patients with dysfunctional eustachian tube is poor compared to patients with good eustachian tube function, which is statistically significant with p value 0.013.</p><p class="abstract"><strong>Conclusions:</strong> Impedence audiometer can very reliably assess and ascertain eustachian tube dysfunction pre-operatively. The outcome of type-1 tympanoplasty in patients with eustachian tube dysfunction is uniformly poor. Better outcome probably would be gained by using more resilient materials like cartilage.</p>

Evaluation of Hearing Status and Eustachian Tube Function in Oral Submucous Fibrosis: A Cross Sectional Study

Introduction Oral Submucous Fibrosis (OSMF) in severe cases involves palatal and paratubal muscles of Eustachian tube leading to Eustachian tube dysfunction and hearing disabilities. This study aims to evaluate to evaluate hearing status and Eustachian tube function in patients of Oral Submucous Fibrosis and to correlate them with various groups of the disease. Materials and Methods A Cross Sectional study was carried out in a Tertiary Care Hospital on diagnosed patients of OSMF. Patients with hearing loss due to other middle ear pathologies or previous ear surgeries were excluded. Patients were classified into various Groups depending on the severityof the disease. They were subjected to Pure Tone Audiometry and Impedance Audiometry. Results obtained were statistically analysed. Results A total of 121 patients (242 ears) were included in the study. On Pure Tone Audiometry, minimal hearing loss was found in 20(8.26%) ears while mild and moderate hearing loss was seen in 26(10.74%) and 28(11.58%) ears respectively. On tympanometry, Type B and Type C tympanograms(abnormal) were seen in 36(14.88) and 26(10.74%) ears, respectively. On Eustachian Tube Function Test, out of 242 ears, 67 ears (27.68%) showed Eustachian tube dysfunction. On using Pearson’s chi square test, significant association was found between degree of hearing loss, type of tympanograms and eustachian tube function with various groups of OSMF (p value < 0.05). Conclusion OSMF may affect hearing efficiency and Eustachian tube function as the disease progresses.

Analysis of effects of laryngopharyngeal reflux disease and proton pump inhibitor treatment on Eustachian tube function in patients with obstructive sleep apnea hypopnea.

This study aims to explore the effects of laryngopharyngeal reflux disease (LPRD) and proton pump inhibitor (PPI) treatment on Eustachian tube function in patients with obstructive sleep apnea (OSA). The Eustachian tube score-7 (ETS-7) was observed before and after PPI treatment in the control group, OSA only group, and OSA + LPRD group. Age, sex, smoking history, and drinking history showed no differences among 3 groups (P > .05). The body mass index (BMI) in the control group was lower than that in other groups (P < .017). Before PPI treatment, the abnormality rate of ETS-7 in the OSA + LPRD group statistically differed from that in the control group and the OSA only group (P < .017). After PPI treatment, the abnormality rate of ETS-7 in the OSA + LPRD group exhibited no significant differences compared with that in the control group and the OSA only group (P > .017), and it declined remarkably compared with that before PPI treatment (75% vs 35%, χ2 = 13.334, P = .001). Moreover, the multivariate analysis revealed that only LPRD had an independent correlation with the abnormality of ETS-7 (OR = 1.245, 95% CI: 1.759-6.861, P = .000). In view of its high incidence in OSA patients, LPRD may be a considerable factor for the high incidence of abnormality rate of ETS-7 in OSA patients, and PPI therapy is of significant value in improving Eustachian tube function in OSA patients with LPRD.

Evaluation of Eustachian tube function in patients of cleft palate and effects of palatoplasty on these findings

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Isolated cleft palate and cleft palate and cleft lip patients have poor Eustachian tube function which results in hearing impairment that too in the speech formative years. Aim of study was to evaluate tympanometric findings in patient of cleft palate and effect of palatoplasty on both short term and long term postoperatively.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; The subjects consisted of patients attending the cleft lip and palate clinic. This was a combined clinic consisting of department of plastic surgery, department of ENT and department of dental surgery held every month at a tertiary care hospital in Delhi. Study consisted of three groups of patients namely preoperative group, postoperative group and pre-postoperative group.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; No significant difference was observed in tympanometric abnormalities in cases of combined cleft lip and palate as compared to isolated cleft palate. After age of 5 months once changes of OME has set in there was no significant change in middle ear findings irrespective of palatal repair.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; There is a very high prevalence of otitis media with effusion in these patients. The changes do resolve spontaneously after age of seven, this perhaps is due to combined effect, growth, development and l maturity of Eustachian tube and palatal surgery rather than palatal surgery alone.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;

Gastroesophageal Reflux Disease: A Cause for Eustachian Tube Dysfunction in Obstructive Sleep Apnea.

To explore the effect of gastroesophageal reflux disease (GERD) on Eustachian tube function in patients with obstructive sleep apnea (OSA). This was a cross-sectional study. The patients were divided into 4 groups according to OSA and GERD: OSA+GERD group; OSA-only group; GERD-only group; and normal control group. There were no differences among the 4 groups regarding age, sex, smoking history, and alcohol history (all P > .05). The patients in the OSA and OSA+GERD groups had a significantly larger body mass index than those in the control and GERD-only groups (all P < .05). The proportions of patients with abnormal ETS-7 and ETD-Q results were higher in the GERD and OSA+GERD groups compared to the control group (P < .008). There were no significant differences in ETS-7 and ETD-Q between the control and the OSA-only groups (P > .008). The multivariable analysis showed that only GERD was independently associated with abnormal ETS-7 results (odds ratio = 3.090, 95% CI: 1.332-7.169, P = .009). Given the high concomitance rate in patients with OSA, GERD might be an important association factor of Eustachian tube dysfunction in patients with OSA.

Eustachian Tube Function in Patients with Symptoms on Baro-Challenge

Objectives: To explore the relationship between aural symptoms during baro-challenge and the underlying measured Eustachian tube (ET) function. Two key questions were addressed. (1) In patients who have features of obstructive ET dysfunction, is there a measurable underlying difference in ET function between those who experience severe symptoms on baro-challenge and those that do not? (2) What is the diagnostic value of ET function tests in the identification of patients with severe symptoms on baro-challenge? Methods: Patients with symptoms of obstructive ET dysfunction were recruited, with the presence of aural symptoms on baro-challenge established via the clinical history and analysis of the Cambridge ET Dysfunction Assessment, a patient-reported outcome measure (PROM). ET function tests were assessed in each patient: 9 objective and semi-objective measures of ET opening, and 2 symptom-based PROMs. The tests’ results were grouped by type of ET opening assessed, generating passive and active dysfunction scores. Individual test results were assessed for diagnostic accuracy in reference to features in the history or PROM-based evidence of symptoms on baro-challenge. Results: Both passive and active opening of the ET was significantly reduced in ears with a history of pain on baro-challenge. Some patients had apparent severe obstructive ET dysfunction without symptoms on baro-challenge, whilst others had symptoms but normal test results. No individual test of ET opening was of diagnostic value in predicting those ears likely to experience pain or exacerbated symptoms on baro-challenge. Conclusion: The relationship between aural pain during baro-challenge and ET function appears more complex than had been assumed, with pain possibly related to factors other than just ET function.

Eustachian tube function in patients with chronic tubotympanic suppurative otitis media with Eustachian tube dysfunction after tympanoplasty

Actuality: In the treatment of chronic tubotympanic suppurative otitis media, one of the main conditions for a successful treatment is a sufficient function of the Eustachian tube (ET). Earlier, the 5th stage of ET function was considered as a contraindication for tympanoplasty. The inflation-deflation test allows accurately assess the degree of dysfunction of the ET and optimize surgical tactics. Aim of the study: To determine the dynamic changes in ET function in patients with chronic tubotympanic suppurative otitis media with dysfunction of ET after tympanoplasty according to the inflationdeflation test. Materials and Methods: We examined 105 patients aged 19 to 56 years, 57 were women and 48 men. At the 1st – 4th grade of ET function according to inflation-deflation test, the result was interpreted as normal – patients underwent tympanoplasty without ventilation tubes (VT). At the 5th stage of ET function, the result was interpreted as abnormal (dysfunction of the ET) – patients underwent tympanoplasty with teflon or silicone VT. Inflation-deflation test was performed in all patients postoperatively after 3, 6, 12 months. With the improvement of ET function (changing grade from 5th to 1-4th, the VT was removed). Results and discussion: Was found that in men, the 5th grade of ET dysfunction is observed less often (37.5%) than in women (52.6%). Improvement of ET function in patients with teflon VT is faster than in patients with silicone VT. At the same time, restoration of the tympanic membrane leads to decrease of the 5th grade of the ET function when comparing between the 3rd and 6th and 12th months, and also between the 6th and 12th months after surgery in both groups of men and women. Conclusions: Tympanoplasty in patients with chronic tubotympanic suppurative otitis media improves the ET function. The inflation deflation test is an objective method and should be the basic examining the ET in the candidate for tympanoplasty.

Assessment of the Effect of Temporomandibular Joint Bony Ankylosis on Eustachian Tube Functions

Objective: This study was designed to evaluate the effect of temporomandibular joint (TMJ) bony ankylosis on Eustachian tube (ET) functions. Subjects and Methods: Twelve patients suffering from TMJ bony ankylosis were selected from those attending the out-patient Clinic of Oral and Maxillofacial Surgery Department, Faculty of Oral and Dental Medicine, Cairo University. Twelve subjects (control group) underwent Eustachian tube function test were selected also. Tympanometry was utilized to assess Eustachian tube function. Three pressure reading (P1, P2, and P3) of the middle ear and external ear canal volume were recorded by the use of tympanometry. Comparisons were performed between patient and control group to evaluate the change of pressure. Results: Throughout the results, four ears showed type (C) tympanogram representing Eustachian tube dysfunction, two ears showed type (B) tympanogram which represent otitis media with effusion. While other ears showed type (A) tympanogram. On comparing the pressure values between the patients and the control, significant decrease was recorded in (P2) value in the patients group and no significant difference existed in the external canal volume. Conclusions: The Eustachian tube function is affected in patients of temporomandibular joint bony ankylosis, it cannot adapt to changes in pressure effectively. Patients of TMJ ankylosis are more liable to develop otitis media. Inflation-deflation test is a reliable method for evaluating Eustachian tube function in patients of (TMJ) ankylosis. The external ear canal volume was not affected in this group of patients.

Usefulness of the Saccharin Test for Assessment of Eustachian Tube Function in Patients With Chronic Otitis Media With Perforation.

The eustachian tube (ET) has two important functions, ventilation and clearance of the middle ear. We evaluated the ET ventilator function by the sonotubometry and the inflation-deflation test that are widely used today, and the ET clearance function by the saccharin test. Results of both tests were compared with surgical outcomes, and assessed which test was more closely related to the surgical outcomes. Prospective case series. A single university hospital. One hundred four ears of 95 patients with chronic otitis media with perforation underwent type I tympanoplasty. Based on sonotubometry and the inflation-deflation test, the patients were divided into normal, stenosis, and patulous types. Based on the saccharin test, they were divided into a normal function group and a partial/gross dysfunction group. Surgical outcomes about the hearing results and the condition of the eardrum were assessed 1 year postoperatively. Preoperative evaluation of ET function was compared with the surgical outcome. Sonotubometry and inflation-deflation tests showed there was no significant difference among the groups about the hearing improvement and the surgical success rate. The saccharin test showed that the rate of the hearing improvement was significantly lower in the gross dysfunction group and that the success rate of Type I tympanoplasty was significantly higher in the normal group than in the dysfunction group. There is a relationship between the saccharin test results and surgical outcomes.

Assessment of Eustachian tube function in patients with tympanic membrane retraction and in normal subjects

IntroductionThe diagnosis of Eustachian tube dysfunctions is essential for better understanding of the pathogenesis of chronic otitis media. A series of tests to assess tube function are described in the literature; however, they are methodologically heterogeneous, with differences ranging from application protocols to standardization of tests and their results. ObjectiveTo evaluate the variation in middle ear pressure in patients with tympanic membrane retraction and in normal patients during tube function tests, as well as to evaluate intra-individual variation between these tests. MethodsAn observational, contemporary, cross-sectional study was conducted, in which the factor under study was the variation in middle ear pressure during tube function tests (Valsalva maneuver, sniff test, Toynbee maneuver) in healthy patients and in patients with mild and moderate/severe tympanic retraction. A total of 38 patients (76 ears) were included in the study. Patients underwent tube function tests at two different time points to determine pressure measurements after each maneuver. Statistical analysis was performed using SPSS software, version 18.0, considering p-values <0.05 as statistically significant. ResultsMean (standard deviation) age was 11 (2.72) years; 55.3% of patients were male and 44.7% female. The prevalence of type A tympanogram was higher among participants with healthy ears and those with mild retraction, whereas type C tympanograms were more frequent in the moderate/severe retraction group. An increase in middle ear pressure was observed during the Valsalva maneuver at the first time point evaluated in all three groups of ears (p=0.012). The variation in pressure was not significant either for the sniff test or for the Toynbee maneuver at the two time points evaluated (p≥0.05). Agreement between measurements obtained at the two different time points was weak to moderate for all tests in all three groups of ears, and the variations in discrepancy between measurements were higher in ears with moderate/severe tympanic retraction. ConclusionIn this study population, the mean pressure in the middle ear showed significant variation only during the Valsalva maneuver at the first time point evaluated in the three groups of ears. Normal ears and those with mild retraction behaved similarly in all tests. The tested maneuvers exhibited weak to moderate intra-individual variation, with the greatest variation occurring in ears with moderate/severe retraction.

Functional MRI of the Eustachian Tubes in Patients With Nasopharyngeal Carcinoma: Correlation With Middle Ear Effusion and Tumor Invasion.

We sought to combine the Valsalva maneuver with MRI to evaluate eustachian tube function in patients with nasopharyngeal carcinoma (NPC) and to correlate the extent of tumor invasion with the presence of middle ear effusion (MEE) and eustachian tube dysfunction (ETD). We performed MRI along the lengths of the eustachian tubes, before and after the Valsalva maneuver was performed, in 53 patients with untreated NPC. The images were reviewed by two radiologists. A total of 106 eustachian tubes and middle ears were studied. There was dysfunction in 37 eustachian tubes, which was always ipsilateral to the NPC. There was MEE in 26 ears of 22 patients. In all cases of MEE, there was ipsilateral ETD. ETD was correlated with tumor invasion of the ipsilateral pharyngeal recess (p < 0.001), pharyngeal opening of the eustachian tube (p < 0.001), the cartilaginous eustachian tube (p < 0.001), the eustachian cartilage (p < 0.001), Ostmann fat pad (p < 0.001), the levator veli palatine muscle (p < 0.001), and the tensor veli palatine muscle (p < 0.001). There was a strong correlation between the grade of parapharyngeal space invasion and ETD (r = 0.809; p < 0.001) and MEE (r = 0.693; p < 0.001). Combining the Valsalva maneuver with MRI is helpful in assessing the function of the eustachian tube in patients with NPC. The cause of MEE in patients with NPC is dysfunction of the eustachian tube opening, which is associated with tumor invasion around the eustachian tube.

Improvement in Eustachian Tube Function after Endoscopic Sinus Surgery for Polypoid Chronic Rhinosinusitis

Objectives: 1) Discuss the evidence for polypoid chronic rhinosinusitis causing Eustachian tube dysfunction and the role of endoscopic sinus surgery. 2) Demonstrate a case report of a patient with otologic complaints of Eustachian tube dysfunction showing that Functional Endoscopic Sinus Surgery (FESS) results in both symptomatic and objective improvement on tympanogram with Toynbee maneuver. Methods: A patient with polypoid chronic rhinosinusitis was assessed with two runs of tympanometry: a run before and after a Toynbee maneuver. The same test was repeated at 12 and 22 weeks after surgery. Results: Preoperatively, there was no shift in the tympanogram in either ear after the Toynbee maneuver. At the first post-operative visit, our patient demonstrated a shift in the tympanogram curve after a Toynbee maneuver in the left ear. At the second visit the patient demonstrated a shift in both ears. The patient also described subjective improvement in symptoms of Eustachian tube dysfunction. Conclusions: This case study demonstrates that endoscopic sinus surgery in patients with chronic rhinosinsitis can improve symptoms of Eustachian tube dysfunction. Improvement in Eustachian tube function can be demonstrated by vigorous testing by shifts in the tympanogram curve after pressurization using the Toynbee maneuver. This suggests that a large prospective study should be performed using subjective and objective measures of Eustachian tube function in patients with otologic complaints and chronic rhinosinusitis. We feel that this unique test is clinically relevant and uses equipment readily available in a standard office rather than more extensive that are restricted to research laboratories.

Eustachian tube function in patients with inner ear disorders

The influence of Eustachian tube (ET) dysfunction on the inner ear fluid pressure and thus on the inner ear function in Meniere's disease has been discussed controversially. So far, most of the studies examining ET function in inner ear disorders indirectly analyzed ET function by tympanometric methods. The present study directly studied ET function in inner ear disorders by sonotubometry. Healthy subjects and patients with Meniere's disease, sudden sensorineural hearing loss, cholesteatoma and chronic suppurative otitis media were examined by sonotubometry. Mean increase of sound pressure intensity (dB) and mean duration of sound pressure increase (s) were analyzed. Highest mean increase of sound pressure intensity was seen in healthy subjects when using >5 dB peaks (11.6 ± 0.7 dB) and >0 dB peaks (9.6 ± 0.6 dB). Comparative analysis including bilateral ears showed decreased ET function in patients with cholesteatoma (p = 0.002) and in patients with Meniere's disease (p = 0.003) when using >0 dB peaks. Examination of each specific ET opening maneuver showed impaired ET function in pathological ears of patients with cholesteatoma and with Meniere's disease, during yawning (p = 0.001; p < 0.001), dry swallowing (p = 0.010; p = 0.049), Toynbee maneuver (p = 0.033; p = 0.032) and drinking (p = 0.044; p = 0.027). Mild ET dysfunction is detected in patients with Meniere's disease by direct sonotubometric assessment of ET function.

Pathophysiology of eustachian tube function in patients with otitis media with effusion

Pathophysiology of eustachian tube function in patients with otitis media with effusion

Eustachian tube function in patients with Meniere's disease

Objective The aim of the present study was to clarify the relationship between Eustachian tube function and inner ear function, especially with respect to the hearing ability of patients with Meniere's disease. Methods Patients with Meniere's disease underwent nystagmic examinations and audiometric measurements, including hearing tests, tympanometry, and Eustachian tube function tests (sonotubometry). We compared the audiometric examination results of normal subjects to those of patients with Meniere's disease. Results Twenty-five percent of patients with Meniere's disease exhibited Eustachian tube dysfunction, but 92% displayed normal tympanometry findings. Their sonotubometry durations and amplitudes were not significantly different from those of normal subjects. However, the patients’ hearing level was significantly correlated to sonotubometry duration and amplitude. Our patients were classified according to the four stages of Meniere's disease: stage 1 ( n = 9); stage 2 ( n = 5); stage 3 ( n = 8); and stage 4 ( n = 2). The incidence of Eustachian tube dysfunction in these four groups of patients were 0% (0/9); 40% (2/5); 38% (3/8); and 50% (1/2), respectively. Conclusion Our study provides evidence demonstrating that treatment of Eustachian tube dysfunction may be useful in preventing the hearing of Meniere's patients from becoming worse.

The role of allergic rhinitis in the development of otitis media with effusion: effect on eustachian tube function

Purpose The pathogenesis of otitis media with effusion (OME) is considered multifactorial, with viral upper respiratory tract infection and eustachian tube dysfunction. Allergy may be related to the pathogenesis of OME or to another etiological factor. We investigated the role of allergic rhinitis (AR) in children with OME and evaluated eustachian tube function in patients with AR. Materials and methods We prospectively analyzed the prevalence of AR, serum eosinophil count, and serum total IgE concentrations in 123 children with OME and in 141 controls. IgE concentration in middle ear effusion was compared in children with OME with and without AR, and eustachian tube function after a nasal provocation test was compared between patients with AR and controls. Results The prevalence of AR in children with OME (28.4%) and control subjects (24.1%) did not differ significantly. These 2 groups also showed no differences in total eosinophil count and serum and middle ear effusion IgE concentration. Abnormalities in eustachian tube function were the same in patients with AR and controls. Conclusions Allergic rhinitis may not be related to the development of OME in children.

Eustachian Tube Function in Patients With Eosinophilic Otitis Media Associated With Bronchial Asthma Evaluated by Sonotubometry

To determine eustachian tube function in patients with asthma and with or without eosinophilic otitis media (EOM), a new middle ear disease entity with a highly viscous middle ear effusion containing many eosinophils and usually associated with bronchial asthma. One of the most important causes of otitis media (OM) is eustachian tube dysfunction. Retrospective case review. A referral center. Twenty patients with EOM and patients with asthma but without OM. We studied eustachian tube function using sonotubometry and a questionnaire. Sonotubometry was also performed on 13 control patients with chronic otitis media (COM) and 7 normal controls. The tubal opening duration was significantly longer in patients with EOM than in patients with asthma but without OM, controls with COM, and normal controls, indicating the presence of patulous eustachian tubes in patients with EOM. Responses to the questionnaire also supported the presence of patulous eustachian tubes in the patients with EOM. The presence of a patulous eustachian tube may be a major cause of EOM in patients with bronchial asthma. In patients with asthma who have a helper T-cell 2-dominant predisposition, a patulous eustachian tube easily allows the entry of antigenic materials into the middle ear, causing eosinophil-dominant inflammation.

Hearing and speech assessment of cleft palate patients after palatal closure: Long-term results

The goal of this study was the development of a clinical methodology to assess speech and hearing impairment 5 years after the primary surgical repair of the cleft and, further, to determine the relative importance and long-term consequences of each cleft type and age to the velopharyngeal and eustachian tube function in patients who did not undergo pharyngeal flap surgery following primary palatoplasty. We evaluated with a certain assessment protocol hearing and speech abilities of 42 patients between 5 and 15 years of age: 9 with CP (cleft of the soft and hard palate), 19 with unilateral cleft lip and palate (UCLP), 14 with bilateral cleft lip and palate (BCLP), surgically treated by a team of surgeons using two different surgical techniques between 18 and 24 months of age. ACCORDING TO OUR RESULTS WE WERE ABLE TO EVALUATE: (a) the impact of hearing impairment to the development of speech in these patients. (b) The relation of hypernasality with compansatory articulation. (c) The influence of cleft type, by means of extent of the cleft palatal musculature, to speech integrity. Sixty-nine percent of our patients presented with mild and moderate hearing loss. Hypernasality was observed in 40.5%, compensatory articulation in 28.5% of our patients. Our findings indicated: (a) a simultaneous appearance of speech and hearing impairment at the same age for each cleft type post-surgically in our patients; (b) that the muscular and vomer complex rather than the anatomic extent of the cleft is a significant factor for speech outcome after surgical repair; and (c) that hypernasality is exacerbated by compensatory articulation.

Eustachian tube dysfunction in allergic rhinitis

To assess eustachian tube function in patients with allergic rhinitis and compare them with a control group. Tympanometry was performed in 130 patients (260 ears), divided into 2 groups: 80 cases with allergic rhinitis and 50 healthy controls. Cases underwent skin hypersensitivity tests. Cases, age 21.1 +/- 14.9; Controls, age 23.9 +/- 15.6. Most frequent skin hypersensitivity: Dermatophagoides pt (62%), Zea Maiz (44%), and Cockroach (37%). Tympanometry of cases showed negative values of peak tympanometric pressure in both children and adults (P < or = 0.05). Among children under 11 years of age, 15.5% tympanograms showed abnormal curves (13% C curves and 3% B curves); among the control group only normal curves were found (type A). Allergic rhinitis patients have a higher risk of eustachian tube dysfunction, particularly during childhood. Tympanometry is a noninvasive, readily available procedure that may be useful in these patients to prevent chronic middle-ear disease.

The evaluation of eustachian tube function in patients with chronic otitis media.

In this study we evaluated eustachian tube function in patients with chronic otitis media and compared the results with normal subjects. Two different eustachian tube function tests were applied to 60 ears of the chronic otitis media group and 146 ears of the control group. While eustachian tube dysfunction was observed in 71.7% of the chronic suppurative otitis media group, it was only seen in 34.9% of the control group.